Coronavirus COVID-19 Update for April 16, 2021

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Clinical Reports

12 Months of Trauma: More Than 3,600 US Health Workers Died in Covid’s First Year
More than 3,600 US healthcare workers died in the first year of the pandemic according to Lost on the Frontline, a 12-month investigation by the Guardian and Kaiser Health News (KHN) to track such deaths.
Characteristics and Disease Severity of US Children and Adolescents Diagnosed With COVID-19
Authors conducted a cohort study to estimate adjusted associations between demographic and clinical characteristics and severe COVID-19 among hospitalized pediatric patients. Among 20 714 pediatric patients with COVID-19, 10 950 (52.9%) were girls, 11 153 (53.8%) were aged 12 to 18 years, 8148 (39.3%) were Hispanic or Latino individuals, 5054 (24.4%) were non-Hispanic Black individuals. Among these patients with COVID-19, 6047 (29.2%) had 1 or more chronic conditions. Among the cohort of 2430 pediatric patients (11.7%) who were hospitalized with COVID-19, 756 (31.1%) experienced severe COVID-19. An increased association of severe COVID-19 was observed among patients with 1 or more chronic conditions vs those with none (AOR, 3.27; 95% CI, 2.44-4.37); in children aged 2 through 5 years or 6 through 11 years vs those aged 12 through 18 years (AORs, 1.53; 95% CI, 1.11-2.13 and 1.53; 95% CI, 1.04-2.23, respectively); and in male vs female patients (AOR, 1.52; 95% CI, 1.26-1.83). There was no statistically significant association between race/ethnicity or insurance type and severe COVID-19.

Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients
This study was designed to compare hospitalization rates, intensive care unit (ICU) admissions and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines. Authors identified 48 440 adult patients with a COVID-19 diagnosis from 1 January 2020 to 21 October 2020, with at least three exercise vital sign measurements from 19 March 2018 to 18 March 2020. Each patient’s self-reported physical activity category (consistently inactive=0–10 min/week, some activity=11–149 min/week, consistently meeting guidelines=150+ min/week) was linked to the risk of hospitalization, ICU admission and death after COVID-19 diagnosis. Authors conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes. Patients with COVID-19 who were consistently inactive had a greater risk of hospitalization (OR 2.26; 95% CI 1.81 to 2.83), admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines. Patients who were consistently inactive also had a greater risk of hospitalization (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity. Consistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. We recommend efforts to promote physical activity be prioritized by public health agencies and incorporated into routine medical care.

Antiviral Therapeutics and Vaccines

Pfizer and BioNT ech Request Regulatory Agencies Expand Emergency Use of Their COVID-19 Vaccine to Adolescents
Pfizer Inc. and BioNTech SE today requested amendments to the U.S. Emergency Use Authorization (EUA) of the Pfizer-BioNTech Vaccine (BNT162b2) to expand the use in adolescents 12 to 15 years of age. The companies plan to request similar rulings by other regulatory authorities worldwide in coming days. These requests are based on Phase 3 trial in adolescents 12 to 15 years of age with or without prior evidence of SARS-CoV-2 infection, which demonstrated 100 percent efficacy and robust antibody response after vaccination with the COVIC-19 vaccine.
Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination
Authors report findings in five patients who presented with venous thrombosis and thrombocytopenia 7 to 10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against coronavirus disease 2019 (Covid-19). The patients were health care workers who were 32 to 54 years of age. All the patients had high levels of antibodies to platelet factor 4–polyanion complexes; however, they had had no previous exposure to heparin. Because the five cases occurred in a population of more than 130,000 vaccinated persons, we propose that they represent a rare vaccine-related variant of spontaneous heparin-induced thrombocytopenia that are referred to as vaccine-induced immune thrombotic thrombocytopenia.

Environmental Studies

Your Guide to Masks (CDC)
CDC recommends that people wear masks in public settings, at events and gatherings, and anywhere they will be around other people. Effective February 2, 2021, masks are required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and in U.S. transportation hubs such as airports and stations.